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The COVID-19 pandemic severely impacted Italian Emergency Departments (EDs), leading to drastic staff reductions, chronic overcrowding, widespread burnout, and an exodus of healthcare providers. Consequently, the ED system faces collapse due to relentless overloading. The authors propose a radical decalogue of provocations to drive structural reform and spark scientific debate on the future of emergency care. The core objective is to restore the ED’s mission by strictly limiting access to acute, time-dependent conditions. This requires diverting non-urgent visits to a genuinely operational territorial network, creating distinct, non-ED managed flows for non-acute or destabilized chronic patients. To reach this aim, a single, national, scientifically validated triage system is essential to reliably distinguish between ED-acute patients and those who belong in alternative settings. To address staff retention, the Decalogue demands increased pay, reduced weekly working hours, optimized night work, and structured work diversification between pre-hospital and intermediate care units to make the profession sustainable. Furthermore, the ED must be restored as the hospital's strategic core, with the emergency physician as team leader. Simultaneously, boarding must end by mandating the transfer of stabilized patients out of the ED. System-wide, the network should be rationalized by concentrating resources in equipped referral centers. Finally, the Decalogue calls for legal protection for emergency professionals (with liability resting on healthcare institutions), the establishment of academic chairs in emergency medicine assigned to emergency physicians, and mandatory research for residents. The authors contend that only bold, radical choices can safeguard the ED system and the entire healthcare infrastructure.